Archive for the ‘Rocky Mountain Spotted Fever’ Category

HHS Working Group Calls for Tick-Borne Disease Strategic Plan

The Tick-Borne Disease Working Group, a federal advisory committee established by Congress in the 21st Century Cures Act, issued its first report Nov. 14.

Nov 15, 2018

The Tick-Borne Disease Working Group, an HHS advisory committee established by Congress in the 21st Century Cures Act, issued its first report Nov. 14. The document recommends that the National Institutes of Health create an NIH tick-borne disease strategic plan to address these diseases, including all stages of Lyme disease; that funding be dedicated within CDC to study babesiosis incidence; that the Department of Defense begin a study of tick-borne disease incidence among active-duty service members and their dependents; and that the Veterans Administration begin a study of tick-borne disease incidence and prevalence among veterans and eligible family members.

The DoD recommendation says the department should compile data on the impact of tick-borne diseases on military readiness and should create education and preparedness programs that address the unique risks service members face during training and on deployment and by their families.

The working group consists of 14 people appointed by the HHS secretary in December 2017. They include scientists, physicians, patients, patient advocates, and representatives of HHS, DoD, and the Office of Management and Budget.

Their report calls Lyme disease a growing public health threat, with about 300,000 new cases reported in the United States every year. A map of U.S. states in the report indicates the hardest-hit states, those reporting more than 12,856 cases each in 2004-2016, include Minnesota, Wisconsin, Pennsylvania, Maryland, Virginia, New York, New Jersey, Massachusetts, and Maine.

Most Lyme disease patients who are diagnosed and treated early can fully recover, but 10-20 percent of patients suffer from persistent symptoms, which for some are chronic and disabling. The report says while studies indicate Lyme disease costs approximately $1.3 billion annually in direct medical costs in the United States,

“a comprehensive understanding of the full economic and societal cost remains unknown. It is likely orders of magnitude higher and potentially a $50- to $100-billion-dollar problem for the United States, although more research is needed.”

On Nov. 14, CDC reported that new data show tick-borne diseases are again on the rise, and that in 2017, state and local health departments reported a record number of cases of tick-borne disease to CDC. Cases of Lyme disease, anaplasmosis/ehrlichiosis, spotted fever rickettsiosis (including Rocky Mountain spotted fever), babesiosis, tularemia, and Powassan virus disease all increased—from 48,610 cases in 2016 to 59,349 cases in 2017. However, the 2017 data capture only a fraction of the number of people with tick-borne illnesses, according to CDC. According to the agency, between 2004 and 2016, the number of reported cases of tick-borne disease doubled and researchers discovered seven new tick-borne pathogens that infect people. The new data are from the Notifiable Disease Surveillance System.

“Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes.”

Abstract
There is insufficient evidence to support screening of various tick-borne diseases (TBD) related microbes alongside Borrelia in patients suffering from TBD. To evaluate the involvement of multiple microbial immune responses in patients experiencing TBD we utilized enzyme-linked immunosorbent assay. Four hundred and thirty-two human serum samples organized into seven categories followed Centers for Disease Control and Prevention two-tier Lyme disease (LD) diagnosis guidelines and Infectious Disease Society of America guidelines for post-treatment Lyme disease syndrome. All patient categories were tested for their immunoglobulin M (IgM) and G (IgG) responses against 20 microbes associated with TBD.Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes. We have established a causal association between TBD patients and TBD associated co-infections and essential opportunistic microbes following Bradford Hill’s criteria. This study indicated an 85% probability that a randomly selected TBD patient will respond to Borrelia and other related TBD microbes rather than to Borrelia alone.

A paradigm shift is required in current healthcare policies to diagnose TBD so that patients can get tested and treated even for opportunistic infections.

Please see link for full article. Snippets below:

Introduction
Tick-borne diseases (TBDs) have become a global public health challenge and will affect over 35% of the global population by 20501. The most common tick-borne bacteria are from the Borrelia burgdorferi sensu lato (s.l.) group. However, ticks can also transmit co-infections like Babesia spp.2, Bartonella spp.3, Brucella spp.4,5,6,7,8, Ehrlichia spp.9, Rickettsia spp.10,11, and tick-borne encephalitis virus12,13,14. In Europe and North America, 4–60% of patients with Lyme disease (LD) were co-infected with Babesia, Anaplasma, or Rickettsia11,15,16. Evidence from mouse and human studies indicate that pathogenesis by various tick-borne associated microbes15,16,17 may cause immune dysfunction and alter, enhance the severity, or suppress the course of infection due to the increased microbial burden18,19,20,21,22. As a consequence of extensive exposure to tick-borne infections15,16,17, patients may develop a weakened immune system22,23, and present evidence of opportunistic infections such as Chlamydia spp.24,25,26,27, Coxsackievirus28, Cytomegalovirus29, Epstein-Barr virus27,29, Human parvovirus B1924, and Mycoplasma spp.30,31. In addition to tick-borne co-infections and non-tick-borne opportunistic infections, pleomorphic Borrelia persistent forms may induce distinct immune responses in patients by having different antigenic properties compared to typical spirochetes32,33,34,35. Nonetheless, current LD diagnostic tools do not include Borrelia persistent forms, tick-borne co-infections, and non-tick-borne opportunistic infections.

The two-tier guidelines36,37,38 for diagnosing LD by the Centers for Disease Control and Prevention (CDC) have been challenged due to the omission of co-infections and non-tick-borne opportunistic infections crucial for comprehensive diagnosis and treatment39,40. Emerging diagnostic solutions have demonstrated the usefulness of multiplex assays to test for LD and tick-borne co-infections41,42. However, these new technologies do not address seroprevalence of non-tick-borne opportunistic infections in patients suffering from TBD and they are limited to certain co-infections41,42. Non-tick-borne opportunistic microbes can manifest an array of symptoms24,29 concerning the heart, kidney, musculoskeletal, and the central nervous system as seen in patients with Lyme related carditis43, nephritis44, arthritis45, and neuropathy46, respectively. Therefore, Chlamydia spp., Coxsackievirus, Cytomegalovirus, Epstein-Barr virus, Human parvovirus B19, Mycoplasma spp., and other non-tick-borne opportunistic microbes play an important role in the differential diagnosis of LD24,29. As the current knowledge regarding non-tick-borne opportunistic microbes is limited to their use in differential diagnosis of LD, it is unclear if LD patients can present both tick-borne co-infections and non-tick-borne opportunistic infections simultaneously.

For the first time, we evaluate the involvement of Borrelia spirochetes, Borrelia persistent forms, tick-borne co-infections, and non-tick-borne opportunistic microbes together in patients suffering from different stages of TBD. To highlight the need for multiplex TBD assays in clinical laboratories, we utilized the Bradford Hill’s causal inference criteria47 to elucidate the likelihood and plausibility of TBD patients responding to multiple microbes rather than one microbe. The goal of this study is to advocate screening for various TBD microbes including non-tick-borne opportunistic microbes to decrease the rate of misdiagnosed or undiagnosed48 cases thereby increasing the health-related quality of life for the patients39, and ultimately influencing new treatment protocol for TBDs.

In Fig. 2A, 51% and 65% of patients had IgM and IgG responses to more than one microbe, whereas 9% and 16% of patients had IgM and IgG responses to only one microbe, respectively. Immune responses to Borrelia persistent forms (all three species) for IgM and IgG were 5–10% higher compared to Borrelia spirochetes in all three species (Fig. 2B). Interestingly, the probability that a randomly selected patient will respond to Borrelia persistent forms rather than the Borrelia spirochetes (Fig. S2) is 80% (d = 1.2) for IgM and 68% for IgG (d = 0.7). Figure 2A and B indicated that IgM and IgG responses by patients from different stages of TBDs are not limited to only Borrelia spirochetes.

In Fig. 3 sub-inlets, more than 50% of the patients reacted to only the individual Borrelia strains suggesting that Borrelia antigens are not cross-reactive. If patients were cross-reacting among antigens, a larger percentage of the patients would be seen with the combination of all three species (Fig. S2). These results provide evidence to suggest that the inclusion of different Borrelia species and their morphologies in current LD diagnostic tools will improve its efficiency.

Discussions
The study outcome indicated that polymicrobial infections existed at all stages of TBD with IgM and IgG responses to several microbes (Fig. 2). Results presented in this study propose that infections in patients suffering from TBDs do not obey the one microbe one disease Germ Theory. Based on these results and substantial literature11,15,16,17,27,49,50,51 on polymicrobial infections in TBD patients, we examined the probability of a causal relationship between TBD patients and polymicrobial infections following Hill’s nine criteria47.

An average effect size of d = 1.5 for IgM and IgG (Fig. 4A) responses is considered very large52. According to common language effect size statistics53, d = 1.5 indicates 85% probability that a randomly selected patient will respond to Borrelia and other TBD microbes rather than to only Borrelia. Reports from countries such as Australia27, Germany49, Netherlands11, Sweden50, the United Kingdom51, the USA15,16, and others indicate that 4% to 60% of patients suffer from LD and other microbes such as Babesia microti and human granulocytic anaplasmosis (HGA). However, previous findings11,15,16,27,49,50,51 are limited to co-infections (i.e., Babesia, Bartonella, Ehrlichia, or Rickettsia species) in patients experiencing a particular stage of LD (such as Erythema migrans). In contrast, a broader spectrum of persistent, co-infections, and opportunistic infections associated with diverse stages of TBD patients have been demonstrated in this study (Fig. 2). From a clinical standpoint, the likelihood for IgM and IgG immune responses by TBD patients to the Borrelia spirochetes versus the Borrelia persistent forms, and responses to just Borrelia versus Borrelia with many other TBD microbes has been quantified for the first time (Fig. S2).

Borrelia pathogenesis could predispose individuals to polymicrobial infections because it can suppress, subvert, or modulate the host’s immune system18,19,20,21,22 to create a niche for colonization by other microbes54. Evidence in animals55 and humans11,15,16,27,49,50,51 frequently indicate co-existence of Borrelia with other TBD associated infections. Interestingly, IgM and IgG immune levels by patients to multiple forms of Borrelia resulted in immune responses to 14 other TBD microbes (Fig. 4B). In contrast, patient responses to either form of Borrelia (spirochetes or persistent forms) resulted in reactions to an average of 8 other TBD microbes (Fig. 4B). Reaction to two forms of Borrelia reflected an increase in disease severity indicating biological gradient for causation as required by Hill’s criteria47.

Multiple microbial infections in TBD patients seem plausible because ticks can carry more than eight different microbes depending on tick species and geography56,57. Moreover, Qiu and colleagues reported the presence of at least 18 bacterial genera shared among three different tick species and up to 127 bacterial genera in Ixodes persulcatus58. Interestingly, research indicates Chlamydia-like organism in Ixodes ricinus ticks and human skin59 that may explain immune responses to Chlamydia spp., seen in this study (Fig. 2). Additionally, prevalence of TBD associated co-infections such as B. abortus, E. chaffeensis, and opportunistic microbes such as C. pneumoniae, C. trachomatis, Cytomegalovirus, Epstein-Barr virus, and M. pneumoniae have been recorded in the general population of Europe and the USA (Table S2). However, true incidence of these microbes is likely to be higher considering underreporting due to asymptomatic infections and differences in diagnostic practices and surveillance systems across Europe and in the USA. More importantly, clinical evidence for multiple microbes has been reported in humans11,15,16,27,49,50,51, and livestock55 to mention the least. Our findings regarding the presence of polymicrobial infections at all stages of TBD further supports the causal relationship between TBD patients and polymicrobial infections (Fig. 2). Various microbial infections in TBD patients have been linked to the reduced health-related quality of life (HRQoL) and increased disease severity39.

An association between multiple infections and TBD patients relates well to other diseases such as periodontal, and respiratory tract diseases. Oral cavities may contain viruses and 500 different bacterial species60. Our findings demonstrate that TBD patients may suffer from multiple bacterial and viral infections (Fig. 4). In respiratory tract diseases, influenza virus can stimulate immunosuppression and predispose patients to bacterial infections causing an increase in disease severity61. Likewise, Borrelia can induce immunosuppression that may predispose patients to other microbial infections causing an increase in disease severity.

Traditionally, positive IgM immune reaction implies an acute infection, and IgG response portrays a dissemination, persistent or memory immunity due to past infections. Depending on when TBD patients seek medical advice, the level of anti-Borrelia antibodies can greatly vary as an Erythema migrans (EM) develops and may present with IgM, IgG, collective IgM/IgG, or IgA62. This study recommends both IgM and IgG in diagnosing TBD (Figs 5 and S4–S6) as unconventional antibody profiles have been portrayed in TBD patients. Presence of long-term IgM and IgG antibodies have been reported in LD patients that were tested by the CDC two-tier system. In 2001, Kalish and colleagues reported anti-Borrelia IgM or IgG persistence in patients that suffered from LD 10–20 years ago63. Similarly, Hilton and co-workers recorded persistent anti-Borrelia IgM response in 97% of late LD patients that were considered cured following an antibiotic treatment64.

Similar events of persistent IgM and IgG antibody reactions were demonstrated in patients treated for Borrelia arthritis and acrodermatitis chronica atrophicans65, chronic cutaneous borreliosis66, and Lyme neuroborreliosis67. A clear phenomenon of immune dysfunction is occurring, which might account for the disparities in LD patient’s antibody profiles and persistence. Borrelia suppresses the immune system by inhibition of antigen-induced lymphocyte proliferation18, reducing Langerhans cells by downregulation of major histocompatibility complex class II molecules on these cells19, stimulating the production of interleukin-10 and anti-inflammatory immunosuppressive cytokine20, and causing disparity in regulation and secretion of cytokines21. Other studies have demonstrated low production or subversion of specific anti-Borrelia antibodies in patients with immune deficiency status22.

In the USA alone, the economic healthcare burden for patients suffering from LD and ongoing symptoms is estimated to be $1.3 billion per year69. Additionally, 83% of all TBD diagnostic tests performed by the commercial laboratories in the USA accounted for only LD70. Globally, the commercial laboratories’ ability to diagnose LD has increased by merely 4% (weighted mean for ELISA sensitivity 62.3%) in the last 20 years71. This study provides evidence regarding polymicrobial infections in patients suffering from different stages of TBDs. Literature analyses and results from this study followed Hill’s criteria indicating a causal association between TBD patients and polymicrobial infections. Also, the study outcomes indicate that patients may not adhere to traditional IgM and IgG responses.

__________________

**Comment**

For the first time, Garg et al. show a 85% probability for multiple infections including not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.

I’m thankful they included Bartonella as that one is often omitted but definitely a player. I’m also thankful for the mention of viruses as they too are in the mix. The mention of the persister form must be recognized as well as many out there deny its existence.

Key Quote: “Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes.”

Tick Project Takes A Deeper Look At Disease

ByJill Sheridan•Oct 19, 2018

(Elizabeth Nicodemus/Flickr)

A project to track ticks in Indiana hosted student scientists at Purdue University last week. The students have been involved in the statewide collection of ticks to better understand what diseases they carry.

Purdue University entomology professor Catherine Hill leads the project. She says a better understanding of what else is inside a tick influences diagnosis and treatment.

“We always think about one tick bite, one pathogen, one disease and that’s not really the case,” says Hill.

The Tick INsider project was created because so many Hoosiers reported difficulty getting an accurate right diagnosis.

“What we’re beginning to understand is that ticks are filled with lots of different bacteria and probably some parasites and protozoa and viruses,” says Hill.

These factors are influenced by what animal the tick feeds on.

The students visited the Purdue labs to learn about how the analysis works.

Hill says students are drawn to this opportunity because of the intersection of environment, entomology and health. Another class of student scientists will be recruited next year.

Nine different diseases have been identified in ticks in Indiana including Rocky Mountain spotted fever and Lyme disease.

One thing is for sure, the idea of numerous pathogens working symbiotically is not even on The Cabal’s radar. No research exists.No treatments are offered – just a “one-size fit’s all” 21 days of doxy to “cure” you of this complex monster, which if you ponder that for just 1 solitary second would be a joke if it wasn’t so deadly.

All His Symptoms Pointed Toward the Flu. But the Test Was Negative.

“I think I’m losing this battle,” the 58-year-old man told his wife one Saturday night nearly a year ago.

While she was at the theater — they’d bought the tickets months earlier — he had to crawl up the stairs on his hands and knees to get to bed. Terrible bone-shaking chills racked him, despite the thick layer of blankets. The chills were followed by sudden blasts of internal heat and drenching sweats that made him kick off the covers — only to haul them back up as the cycle repeated itself.

“I need to go to the E.R.,” he told his wife. He’d been there three times already. They’d give him intravenous fluids and send him home with the diagnosis of a viral syndrome. He would start to feel better soon, he was told. But he didn’t.

Too Sick to Work

This all began nine days before. That first day he called in sick to his job as a physical therapist. He felt feverish and achy,as if he had the flu. He decided to drink plenty of fluids, take it easy and go back to work the next day. But the next day he felt even worse. That’s when the fever and chills really kicked in. He was alternating between acetaminophen and ibuprofen, but the fever never let up. He’d started sleeping in the guest room because his sweat was soaking the sheets, and his chills shook the bed, waking his wife.

After three days of this, he made his first visit to the Yale New Haven Hospital emergency room. He was already taking antibiotics. Several weekends earlier, he developed a red, swollen elbow and went to an urgent-care center, where he was started on one antibiotic for a presumed infection. He took it for 10 days, but his elbow was still killing him. He went back to urgent care, where he was started on a broader-spectrum drug, which he had nearly finished. Now his elbow was fine. It was the rest of his body that ached as if he had the flu.

But at the hospital, his flu swab was negative. So was his chest X-ray. It was probably just a virus, he was told. He should take it easy until it passed. And come back if he got any worse.

High Fever

The next day his fever spiked above 105. He went again to the E.R. It was a mob scene — crowded with people who, like him, appeared to have the flu. It would be hours before he could be seen, he was told, because they already knew he didn’t have it. Discouraged, he went home to bed. He went back the next morning after a nurse called to say the E.R. was more manageable.

He might not have the flu, he thought, but he was sure he had something. But the E.R. doctor didn’t know what. He didn’t have chest pain or shortness of breath. No cough, no headache, no rash, no abdominal pain, no urinary symptoms. He felt weak but no longer achy. His heart was beating hard and fast, but otherwise his exam was fine. His white count was low — which was a little strange. White blood cells are expected to increase with an acute infection. Still, a virus can cause white counts to drop. His platelets — the tiny blood fragments that form clots — were also low. That can also be seen in viral infections, but it was less common.

No Help From His Internist

The E.R. staff sent the abnormal blood results to the patient’s primary-care provider and told the patient to follow up with him. He’d been trying get in to see him for days, but the doctor’s schedule was full. When he called again, he was told that the soonest he could be seen was the following week.

The patient asked the doctor to order blood tests to look for an infection in his blood. And could they also test him for tick-borne infections? This was Connecticut, after all. He dragged himself to the lab and then waited for his doctor to call with the results. The call never came. In his mind, he fired his doctor. He’d been sick for over a week, and the doctor’s office couldn’t arrange an appointment, and they couldn’t even call him with the lab results for the test he had to ask for in the first place.

Back to the Hospital

That Sunday morning after the man’s wife had been to the theater, he went once more to the emergency room. It was brought to the attention of the physician assistant on duty that the man had been there several times before and had lab abnormalities. She ordered a bunch of blood tests — looking for everything from H.I.V. to mono. She ordered another chest X-ray and started him on broad-spectrum antibiotics, as well as doxycycline, an antibiotic often used for tick-borne infections. He was given Tylenol for his fever and admitted to the hospital. As he was preparing to leave the emergency department, a new flu test came back positive. He was pretty sure he didn’t have it; he’d never heard of a flu being this bad for this long. But if he could stay in the hospital, where someone could monitor him, he was happy to take Tamiflu.

The lab called again the next day to say that the test had been read incorrectly; he did not have the flu. By then other results started to come in. It wasn’t an infection in his elbow. He didn’t have H.I.V.; he didn’t have mono or Lyme; he didn’t have any of the other respiratory viruses that, along with the worse influenza outbreak in years, had filled up so much of the hospital.

CreditIllustration by Andreas Samuelsson

Getting Better

Yet after a couple of days, the patient began to feel better. His fever came down. The shaking chills disappeared. His white count and platelets edged up. It was clear he was recovering, but from what? More blood tests were ordered, and an infectious-disease specialist consulted.

Gabriel Vilchez, the infectious-disease specialist in training, reviewed the chart and examined the patient. He thought that the patient most likely had a tick-borne infection. The hospital had sent off blood to test for the usual suspects in the Northeast: Lyme, babesiosis, ehrlichiosis and anaplasmosis. Except for the Lyme test, which was negative, none of the results had come back yet. Vilchez considered that given the patient’s symptoms — and his response to the doxycycline — it would turn out that he’d have one of them.

And yet, the results for tick-borne infections were negative. Vilchez thought about other tick-borne diseases that are not on the usual panel. The most likely was Rocky Mountain spotted fever (R.M.S.F.).The name is a misnomer: R.M.S.F. is much more common in the Smoky Mountains than the Rocky Mountains, and the spotted-fever part, the rash, is not seen in all cases. It’s unusual to acquire the infection in Connecticut but not unheard-of. Vilchez sent off blood to be tested for R.M.S.F. The following day, the patient felt well enough to go home. A couple of days later, he got a call. He had Rocky Mountain spotted fever.

A Diagnostic Delay

Why did the diagnosis take so long? The patient had an unusual infection. But perhaps the bigger issue was that he was one of many patients in the emergency room with flulike symptoms in the midst of a flu epidemic. Under those circumstances, the question for the staff simply becomes: Does he have the flu? When the answer is no, doctors tend to move on to the next very sick patient in line. It’s hard to get back to the question of what the nonflu patient does have.

For the patient, recovery has been tough. Though the antibiotic helped with the acute symptoms, it took months before he had the stamina to resume his usual patient load at work. He feels that the illness brought him as close to dying as he had ever been. Indeed, Rocky Mountain spotted fever is one of the most dangerous of all the tick-borne infections, with a mortality rate as high as 5 percent even with current antibiotics.

One thing he was certain about, however: He needed a new primary-care doctor. And he got one.

Lisa Sanders, M.D., is a contributing writer for the magazine and the author of “Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis.” If you have a solved case to share with Dr. Sanders, write her at Lisa.Sandersmd@gmail.com.

________________

**Comment**

This is playing out all over the world. He was one of the lucky ones to finally get an accurate diagnosis.

It is interesting; however, that they are quick to state he doesn’t have the other tick-borne infectionswhen the testing for all of them misses over half of all cases. Once they gave him doxy, they should have retested him. This is called a “provocation test” and is used by many LLMD’s (Lyme literate doctors) as they’ve learned this often finally shows an active infection(s) due to the ability of the body to NOW see the pathogens in the blood stream allowing antibodies to be made and picked up by the tests.

RMSF is a nasty beast on it’s own; however, this man should be monitored over time. If symptoms come back or new ones show up, TBI’s should be suspected.

It’s also a mind boggler how in Connecticut of all places, TBI’s wouldn’t be the FIRST thing medical practitioners think of. It’s literally ground zero.

https://madisonarealymesupportgroup.com/2018/08/16/new-tick-causes-epidemic-of-rmsf/ It’s usually spread by the American dog tick and the closely related Rocky Mountain wood tick. But in recent years the bacterial infection has also been spread by the brown dog tick — a completely different species…The researchers were investigating an epidemic of the infection that broke out in the border town of Mexicali starting in 2008. It’s already sickened at least 4,000 people, according to Mexican government estimates. Several hundred have died, and at least four people have died in the U.S. after crossing the border, according to this report and others.

“I was absolutely startled,” Foley said in an interview.

The people who had been sickened in Mexicali had a heavy load of the infectious agent in their blood — something that had not been seen in past outbreaks.The epidemic is worrisome because the brown dog tick is more likely to bite people and it adapts easily to living in a house, as opposed to living on wild animals, the researchers said.

“The Rocky Mountain spotted fever epidemic in Mexicali has not been contained and may be spreading to other parts of Baja California and into the United States,” the team wrote.

And now it’s possible that for some reason, the infection the brown dog tick transmits is more virulent, Foley said.

Wiser words were never spoken.

P.s. Regarding the red, swollen elbow…..

My journey was similar with the same issue in both my elbow and knee in the middle of January in Wisconsin. I was told, and I promise I didn’t make this up, that I had “Washer Woman’s Knee,” and “Barstool elbow.”

I kid you not.

Now, first, I use a mop and rarely get on my knees. Second, I assure you, I’m not sitting at the bar and have NO reason to have a red, swollen, excruciatingly painful elbow.

Please remember, Lyme is the rock star we all know by name. There are many, many other players involved and people are often coinfected. Mainstream medicine has yet to accept and deal with this very real fact.

New England scientists explore new method for eradicating Lyme disease

Patrick Varine
Wednesday, Oct. 3, 2018, 5:03 p.m.

This undated file photo provided by the U.S. Centers for Disease Control and Prevention shows a blacklegged tick, also known as a deer tick, a carrier of Lyme disease.
AP

Pennsylvania is No. 1 in an unfortunate category: number of Lyme disease cases, which spiked between 2016 and 2017 according to a Quest Diagnostics report released this summer.

With more than 10,000 infections reported in the state last year, it might seem that any solution is worth trying. (**Please see my comment at end of article**)

In New England, scientists from Harvard, MIT and Tufts University have begun genetically engineering white-footed mice — which in the wild carry the Borrelia microbe that causes Lyme disease and pass it along to ticks that feed on their blood — to produce antibodies resistant to both ticks and a particular Borrelia protein. The idea is that immunizing the mice will have a trickle-down effect to the local tick population.

The plan is to eventually release small groups of mice on local islands off the coast of Massachusetts, where they can be isolated for study, to look at potential options for larger application.

For Dr. Bill Rawls of North Carolina, who contracted Lyme disease and is the author of “Unlocking Lyme,” the solution is much more complex.

“There are a lot of microbes in ticks, not just the Borrelia microbe that is associated with Lyme disease,” said Dr. Rawls, medical director for Vital Plan, an herbal supplement company. “The problem with the mouse thing is that even if it is successful, and you block the transmission of Borrelia and prevent the spread of that variety of Lyme disease, perhaps that opens the door to something worse, like Rickettsia, (a microbe associated with the spread of Rocky Mountain Spotted Fever).”

As an advocate of holistic medicine, Dr. Rawls said the increase in Lyme cases, as well as the way it affects humans, is symptomatic of a changing world.

“We’ve radically changed our food supply, we all live under oppressive stress and we don’t exercise,” he said. “And all of those factors affect our immune systems. I think it’s time our society starts looking at problems like Lyme disease in that light.”

The Borrelia microbe has been around for millions of years, as have ticks, Dr. Rawls said.

“So the question is: why are people getting much more sick with it now?” he said. “I see Lyme disease as a fundamental model for all chronic illness.”

Dr. Sam Donta, a Western Pennsylvania native who now lives in Falmouth, Mass., was the keynote speaker at the 2018 Pennsylvania Lyme Medical Conference, held this spring at Drexel University College of Medicine. He has been studying Lyme for three decades, and echoed Dr. Rawls’ view that it is a complex illness.

It is also difficult to diagnose, he said. There is no blood test to see if a person is infected.

“All the blood tests say is whether a person has been exposed,” Dr. Donta said. “I diagnose it clinically. It is a combination of symptoms.”

Those symptoms can be fatal.

The PA Lyme Resource Network is partnering with Storyhouse Documentary Theater to present “The Little Things” on Oct. 13 at Ursinus College in Collegeville outside Philadelphia. It tells the story of a family who lost their son to Lyme disease, and is being dedicated to the memory of three eastern Pennsylvania men who died of Lyme-related complications in 2017.

One of those men, Kevin Furey of Lafayette Hill, Pa., contracted five different infections from one tick bite, according to network officials.

Dr. Rawls said he is not suggesting that the white-footed house proposal is futile,

“but there’s the old saying: don’t mess with Mother Nature,” he said. “If you eliminate this microbe, do you open up other pathways for other infections?”

Oops.

Geneticist and virologist Jonathan Latham, Executive Director of the Bioscience Resource Project and editor of Independent Science News, has spoken out about the fallacy of industry talking points in the past.

While it all seems neat and tidy on paper and in a cool colored video, what happens in the wild could be an entirely different matter. Releasing GMO mosquitoes to supposedly eradicate Zika has shown many undesirable effects: https://articles.mercola.com/sites/articles/archive/2016/11/08/zika-virus-wolbachia-mosquito.aspxThe $18-million project, funded in part by the Bill and Melinda Gates Foundation, involves mosquitoes that have been infected with Wolbachia bacteria, which stops viruses from growing inside the mosquito and therefore from being transmitted between people.

According to a study by Penn State, mosquitoes infected with Wolbachia are more likely to become infected with West Nile – which will then be transmitted to humans.“This is the first study to demonstrate that Wolbachia can enhance a human pathogen in a mosquito,“ one researcher said. “The results suggest that caution should be used when releasing Wolbachia-infected mosquitoes into nature to control vector-borne diseases of humans.” “Multiple studies suggest that Wolbachia may enhance some Plasmodium parasites in mosquitoes, thus increasing the frequency of malaria transmission to rodents and birds,” he said. https://www.sciencedaily.com/releases/2014/07/140710141628.htm So besides very probable wide spread inflammation, and that other diseases may become more prevalent due to Wolbachia laced mosquitoes, studies show Wolbachia enhances Malaria in mosquitos. Many Lyme/MSIDS patients already struggle with Babesia, a malarial-like organism.

Emma Haapaniemi, a co-author of the Karolinska Institute study, explained why this is such a concerning find.

“By picking cells that have successfully repaired the damaged gene we intended to fix, we might inadvertently also pick cells without functional p53.” Dysfunctional p53 is a major cancer risk; nearly half of ovarian and colorectal cancers can be connected to a disruption in p53. Many other types of cancer, like lung, pancreatic, stomach, liver and breast cancers, can also be attributed to p53 problems.

“If transplanted into a patient, as in gene therapy for inherited diseases, such cells could give rise to cancer, raising concerns for the safety of CRISPR-based gene therapies,” Haapaniemi added.

“It is essential that national regulatory authorities and international organizations get on top of this — really get on top of it,” says Kenneth Oye, a political scientist at the Massachusetts Institute of Technology and lead author of the Science commentary. “We need more action.” The US National Research Council has formed a panel to discuss gene drives, and other high-level discussions are starting to take place, but Oye is concerned that regulatory changes may happen only after a high-profile gene-drive release, in other words, after it’s too late. (For a five minute audio of reporter Kerri Smith investigating the meteoric rise of CRISPR click on the link above.

On top of those difficulties, scientists do not know how all of this will affect ecosystems and are unclear if the gene drives could spread to closely related species.

“add a twist – introducing one gene drive after another to correct unforeseen consequences as they are discovered,” and that “decisions by researchers would become permanently written into the genomes of entire wild populations.” He also adds that there are alternative ways to wipe out local populations of mosquitoes carrying disease that are much safer.

In this same vein, David Burwitz of Tel Aviv University, feels that gene drive research should be classified to prevent weapon development, and he’s not alone.http://nextstageprep.com/gene-drivesthis-next-weapon-mass-destruction/ In theory, a terrorist could create a handful of insects with a gene for making a toxin, and power it with a gene drive. Pretty soon, all of these insects would make the toxin, and every insect bite would be lethal. However, according to Austin Burt, who proposed the theoretical method for making gene drives, the gene drives only work in sexually reproducing species, unlike the vast majority of genetically engineered microbes which produce asexually and they’ve only been shown to work for one generation – so far.

I’m with Dr. Rawls and Dr. Donta, “Don’t mess with Mother Nature.” That’s what got us in this mess to begin with.

August, 2018: Nymphal deer ticks are less abundant but still active in Wisconsin right now. About 20-25% of nymphs are infected with the Lyme spirochete. Overall, 2018 has been normal in terms of tick numbers.

NEW for 2018: We are starting a tick identification service. Identifying the stage and species of a tick are crucial to deciding whether to seek medical attention or not. Tick-borne diseases are only carried by certain ticks in specific regions. We can help you identify the tick you’ve found based on your images and geographical location. Use the following link to submit your photos and information:

There is also a tab titled “Tick-Borne Diseases.” Go to link to read about them. They give WI stats as well. Please remember ALL the numbers are low as many go unreported:

Lyme (Bb or Bm)

Borrelia miyamotoi (relapsing fever)

Anasplasmosis

Ehrlichia muris eauclairensis (EML)

Babesiosis

Powassan virus/deertick virus

Ehrlichia chaffeensis

Rocky Mountain Spotted Fever

__________________

A few points stick out to me:

Please take pictures of these ticks & send them in so we finally have an accurate record. They are asking us for help so let’s give it. It will only help us in the end. Flood them with ticks!

Baronella didn’t make the list, yet nearly everyone I work with has it. WHY? Because while Bart has been found in ticks, it hasn’t been proven conclusively they transmit. Bart is a nasty, nasty bug and alone can kill you. Coupled with Lyme it can make you want to die.

The lack of data is glaring. Seriously. Glaring. Zika makes front page news here and our mosquitoes can’t even carry it. https://madisonarealymesupportgroup.com/2018/03/13/wed-nite-the-lab-talk-on-mosquitoes-ticks-disease/ There were only 46 cases of Zika in the U.S. in 2018 – ALL due to travelers returning from affected areas.The CDC “estimates” that there are 300,000 NEW Lyme Disease cases annually in the U.S. Anyone see a disparity here between Zika and Lyme? (Other tick-borne diseases aren’t even on the radar yet)

The failure to test for Ehrlichia, even as more and more evidence suggests that the infection may be just as common as other endemic tick-borne diseases, appears to impact patient care with antibiotics prescribed less frequently when testing is not ordered. This study’s results and recommendation for increased provider education were recently published in the Center for Disease Control and Prevention’s journal Emerging Infectious Diseases.

“Providers order Ehrlichia testing much less frequently than Rocky Mountain Spotted Fever or even Lyme disease, despite the low-incidence of Lyme disease in the state,” said Ross Boyce, M.D., M.Sc., the study’s lead author and a clinical instructor in the Division of Infectious Diseases at the UNC School of Medicine. “This disparity may be attributable to unfamiliarity with local vector epidemiology, as well as the greater attention given to Rocky Mountain Spotted Fever and Lyme disease in the popular media.”

Ehrlichia is an illness caused by the Lone Star Tick, which is found throughout the mid-Atlantic United States. Symptoms typically include fever, headache and muscle aches. Boyce and colleagues performed a retrospective chart review on 194 patients who underwent testing for tick-borne illness at UNC hospitals and associated clinics between June and September 2016.

They found that nearly 80 percent of patients were tested for Rocky Mountain Spotted Fever and two-thirds were tested for Lyme disease. Yet providers ordered testing for Ehrlichia in only one-third of patients. Among the initial results

Using leftover serum, Boyce and colleagues tested the 124 patient samples that were not initially tested for Ehrlichia. Twenty-five of those samples ultimately tested positive for Ehrlichia,

putting the total number of positive results nearly equal with the number of Rocky Mountain Spotted Fever cases.

“Our results demonstrate that Ehrlichia accounted for a large proportion of reactive antibodies among a cohort of individuals with suspected tick-borne illness in Central North Carolina,” Boyce said. “These finding provide strong, albeit circumstantial evidence that Ehrlichia infection is as prevalent as Rocky Mountain Spotted Fever even as providers appear to consider this diagnosis much less frequently than other tick-borne diseases.”

While the CDC guidelines recommend empirical antibiotic treatment when there is suspicion for tick-borne illness, Boyce and colleagues work suggests that providers are less likely to provide antibiotics if testing is not ordered. While it is difficult to distinguish an acute infection from a past exposure with a single test, the study estimates that failure to test for Ehrlichia may have resulted in a missed diagnosis in more than 10 percent of individuals.

Boyce said educating front-line providers in primary care clinics and emergency departments about the prevalence of this tick-borne illness is urgently needed.

_______________

**Comment**

Great example of the importance of medical practitioners understanding clearly that ticks are infected with many pathogens that can and do infect humans causing disease. They need to ditch the one pathogen, one drug paradigm completely or patients are not going to improve.